Provider Demographics
NPI:1578635108
Name:VARNEY PHARMACY LLC
Entity Type:Organization
Organization Name:VARNEY PHARMACY LLC
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:VARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:605-928-3661
Mailing Address - Street 1:PO BOX 1220
Mailing Address - Street 2:
Mailing Address - City:PARKSTON
Mailing Address - State:SD
Mailing Address - Zip Code:57366-1220
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:102 WEST MAIN
Practice Address - Street 2:
Practice Address - City:PARKSTON
Practice Address - State:SD
Practice Address - Zip Code:57366
Practice Address - Country:US
Practice Address - Phone:605-928-3661
Practice Address - Fax:605-928-7362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1001815333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9167310Medicaid
4300656OtherOTHER ID NUMBER-COMMERCIAL NUMBER
4300656OtherOTHER ID NUMBER-COMMERCIAL NUMBER
SDBV6984997OtherDEA #